title: Measurement of distress and its alteration during treatment in patients with nasopharyngeal carcinoma.
abstract: BACKGROUND
  We examined the criterion-related validity of the Distress Thermometer (DT) for screening distress in patients with nasopharyngeal carcinoma (NPC) and investigated prospectively how distress changes.
  
  
  METHODS
  In the cross-sectional study, the DT was tested against the Hospital Anxiety and Depression Scale (HADS) in 295 patients with NPC. In the prospective study, 61 newly diagnosed patients with NPC completed the DT and HADS 6 times.
  
  
  RESULTS
  Adopting HADS as the standard tool for screening distress, 31.5% of the patients with NPC had distress. A DT cutoff score ≥ 4 had best sensitivity (0.73) and specificity (0.85). In the prospective study, the proportion of patients with distress rose significantly during treatment.
  
  
  CONCLUSIONS
  Receiver operating characteristic (ROC) findings provide initial support for the validity of the DT among patients with NPC. Nearly one third of patients with NPC exceeded cutoff values for distress in the cross-sectional study. In the prospective study, the level of distress increased significantly during concurrent chemoradiotherapy for patients with NPC.
authors.affiliation: Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
authors.forename: Yao-Tiao
authors.initials: YT
authors.lastname: Deng
authors.forename: Wu-Ning
authors.initials: WN
authors.lastname: Zhong
authors.forename: Yu
authors.initials: Y
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000523:psychology*; D011446:Prospective Studies; D011594:Psychometrics; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013315:Stress, Psychological / Q000175:diagnosis*; D011795:Surveys and Questionnaires
keywords: concurrent chemoradiotherapy; distress; distress thermometer; nasopharyngeal carcinoma; screening